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特发性机化性肺炎:17 例患者的临床和放射学特征、治疗结果及文献复习。

Cryptogenic organizing pneumonia: clinical and radiological features, treatment outcomes of 17 patients, and review of the literature.

机构信息

Department of Chest Diseases, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey.

出版信息

Turk J Med Sci. 2016 Dec 20;46(6):1712-1718. doi: 10.3906/sag-1508-114.

Abstract

BACKGROUND/AIM: We evaluated patients with cryptogenic organizing pneumonia (COP) who attended our clinic.

MATERIALS AND METHODS

We retrospectively investigated the clinical and radiological findings, diagnostic methods, treatment, and follow-up outcomes of 17 patients who had been histopathologically diagnosed with COP.

RESULTS

The mean age of the patients was 49.8 ± 10.4 years. The most common symptom was cough (n = 15; 88.2%) and the most common radiological finding (n = 10) was consolidation in the inferior lobes on thoracic computed tomography. The diagnosis of COP was made by open lung biopsy in 11 (64.7%) patients, transbronchial biopsy in 5 (29.4%), and video-assisted thoracoscopic surgery biopsy in 1 (5.9%). The mean follow-up period was 28.7 ± 25.0 (range: 3-85) months. Twelve patients received oral corticosteroid therapy and seven of them improved without any fibrotic changes. One patient refused treatment; a chest radiography of that patient was found to be normal at the end of the 20-month follow-up period. Three patients received no other therapy, as the lesion had been completely excised.

CONCLUSION

Common symptoms included cough and dyspnea, while the main radiological presentation of COP was consolidation. Corticosteroids are a good treatment option in general, but relapse may occur.

摘要

背景/目的:我们评估了在我院就诊的隐源性机化性肺炎(COP)患者。

材料与方法

我们回顾性调查了 17 例经组织病理学诊断为 COP 的患者的临床和影像学表现、诊断方法、治疗及随访结果。

结果

患者的平均年龄为 49.8±10.4 岁。最常见的症状是咳嗽(n=15;88.2%),最常见的影像学表现(n=10)是胸部 CT 下叶实变。11 例(64.7%)患者通过开胸肺活检、5 例(29.4%)患者通过经支气管活检、1 例(5.9%)患者通过电视辅助胸腔镜活检确诊为 COP。平均随访时间为 28.7±25.0(范围:3-85)个月。12 例患者接受了口服皮质类固醇治疗,其中 7 例无纤维化改变。1 例患者拒绝治疗,在 20 个月的随访期末,该患者的胸部 X 线片显示正常。3 例患者未接受其他治疗,因为病变已完全切除。

结论

常见症状包括咳嗽和呼吸困难,COP 的主要影像学表现为实变。皮质类固醇通常是一种较好的治疗选择,但可能会复发。

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